Dissociation : Vol. 5, No. 3, p. 127-140 : Abreaction re-evaluated

Contemporary clinicians working in the field of multiple personality disorder (MPD) generally agree that pathogenic traumatic memories are at the root of this dissociative disorder. Examination of contemporary studies, however, shows that diagnostic and therapeutic conceptualization remains muddled and frequently contradictory. This confusion stems back to Breuer and Freud's "Studies of Hysteria," in which they used two contradictory models concerning the nature and treatment of traumatic memories. The first model was in terms of dissociation and integration, processes which already had a French pedigree (particularly with Pierre Janet), and the second was their own model which they developed in terms of the principle of psychological constancy and abreaction. In the literature on trauma since Breuer and Freud, e.g., studies on post-traumatic stress during and after World Wars I and II and the Vietnam war, different authors have emphasized either one or both models. The present authors critically re-evaluate abreaction and advocate the dissociation-integration model as the basis for further conceptualization, discussing the role of emotional expression within it.